Organization
PARVATHI POKALA DDS INCORPORATED
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PARVATHI KOKA POKALA DDS (OWNER)
(858) 274-0722
Entity
Organization
Contact information
Practice address
3737 MORAGA AVE STE B313, SAN DIEGO, CA 92117-5481
(858) 274-0722
(858) 274-1175
Mailing address
3737 MORAGA AVE STE B313, SAN DIEGO, CA 92117-5481
(858) 274-0722
(858) 274-1175
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
40296
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G92041-01
DENTICAL IDENTIFICATION
CA
Enumeration date
12/12/2007
Last updated
12/12/2007
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